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Supplementation after a bariatric surgery is necessary because the surgery causes a decrease in the absorption of vitamins and minerals. The most important causes for malabsorption are:
  • Smaller stomach: A stomach reduction causes you to eat less. However, it also means that your body absorbs less nutrients out of food.
  • Food intolerance: This is a possible complication after the surgery. Some patients can no longer handle certain food such as red meat and dairy products, high in protein, vitamin B12, and iron.
  • Fewer/no production of gastric acid: Gastric acid is responsible for retracting vitamins and minerals from your food.
  • Fewer/no production of intrinsic factor: Intrinsic factor is a type of protein that transports vitamin B12 and enables its active absorption.
  • Bypass of the first section of the small intestine (this is not the case in Sleeve Gastrectomy): The absorption of nutrients mostly takes place in the first section of the small intestine. However, in all bariatric surgeries (except for the Sleeve Gastrectomy) this section is bypassed. So, the vitamins and minerals no longer pass through the section where they are actively absorbed.